Individual provider Active NPI

Bennie H Jeng, MD

  • Ophthalmology Physician
  • Philadelphia, PA
National Provider Identifier
1104852870
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD478378 Issued in PA
Practice address
3400 Civic Cente Blvd
Philadelphia, PA 19104
Phone
(667) 214-1232
NPI assigned
Jun 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A79800 CA
Ophthalmology Physician 207W00000X MD478378 PA Primary
Ophthalmology Physician 207W00000X 35082112J OH
Ophthalmology Physician 207W00000X D76471 MD

Addresses

Primary practice location

3400 Civic Cente Blvd
Philadelphia, PA 19104

Mailing address

3400 Civic Cente Blvd
Philadelphia, PA 19104

Other identifiers 2

IdentifierTypeStateIssuer
114512600MedicaidMD
2423505MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, PA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130814000574 MD Practitioner - Ophthalmology 9032114491 Reassigns benefits to 1 organization
I20220812001935 PA Practitioner - Ophthalmology 9032114491 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Perelman School of Med at the University of Pennsylvania, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

3400 Civic Ctr Blvd
Philadelphia, PA 19104-5127
Phone (215) 614-4100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery59

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35082112OHMDPain Medicine (Anesthesiology) Physician
D76471MDMDOphthalmology Physician
35082112JOHMDOphthalmology Physician
MD478378PAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Eye Associates, P.a. CurrentSince Aug 1, 2013 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
University of Penn-Medical Group CurrentSince Jul 1, 2022 Accepting new patients
University of Maryland Eye Associates, P.a. Ophthalmology CurrentSince Aug 1, 2013 Accepting new patients
University of Penn-Medical Group CurrentSince Jul 1, 2022 Accepting new patients
University of Penn - Medical Group Past Accepting new patients

Locations

419 W Redwood St
Ste 470
Baltimore, MD 21201
Phone (667) 214-1197

419 W Redwood St
Ste 420
Baltimore, MD 21201
Phone (410) 328-6533

601 W State St
Media, PA 19063
Phone (610) 565-6863

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

3400 Civic Center Blvd
#3W
Philadelphia, PA 19104
Phone (215) 615-0063

145 King of Prussia Rd
Ste 204
Radnor, PA 19087
Phone (610) 902-2020

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1104852870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTE BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTE BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "667-214-1232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENG",
        "first_name": "BENNIE",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-24",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A79800",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD478378",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "35082112J",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "D76471",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114512600",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2423505",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.